Maahs D.M.,University of Colorado at Denver |
Maahs D.M.,Childrens Hospital Colorado |
Dabelea D.,University of Colorado at Denver |
Shah A.S.,University of Cincinnati |
And 9 more authors.
Journal of Pediatrics | Year: 2013
Objective: To test the hypothesis that a change in glycated hemoglobin (A1c) over a follow-up interval of approximately 2 years would be associated with concomitant changes in fasting lipids in individuals with type 1 diabetes (T1D). Study design: All subjects with T1D diagnosed in 2002-2005 in the SEARCH for Diabetes in Youth study with at least 2 study visits ∼12 and ∼24 months after an initial visit were included (age at initial visit, 10.6 ± 4.1 years; 48% female; diabetes duration, 10 ± 7 months; 76% non-Hispanic white; A1c = 7.7% ± 1.4%). Longitudinal mixed models were fit to examine the relationship between change in A1c and change in lipid levels (total cholesterol [TC], high-density lipoprotein-cholesterol [HDL-c], low-density lipoprotein-cholesterol [LDL-c], log triglycerides [TG], and non-HDL-c) with adjustment for possible confounders. Results: Change in A1c over time was significantly associated with changes in TC, HDL-c, LDL-c, TG, and non-HDL-c over the range of A1c values. For example, for a person with an A1c of 10% and then a 2% decrease in A1c 2 years later (to 8%), the model predicted concomitant changes in TC (-0.29 mmol/L, -11.4 mg/dL), HDL-c (0.03 mmol/L, 1.3 mg/dL), LDL-c (-0.23 mmol/L, -9.0 mg/dL), and non-HDL-c (-0.32 mmol/L, -12.4 mg/dL) and an 8.5% decrease in TG (mmol/L). Conclusions: Improved glucose control over a 2-year follow-up was associated with a more favorable lipid profile but may be insufficient to normalize lipids in dyslipidemic T1D youth needing to decrease lipids to goal. Copyright © 2013 Mosby Inc.
News Article | February 28, 2017
A new report published in the Feb. 28 issue of the Journal of the American Medical Association points to a significantly higher burden of diabetes-related complications in adolescents and young adults with type 2 diabetes compared to type 1 diabetes, with greater health complications in minority youth. The study, from researchers involved with the nationwide SEARCH for Diabetes in Youth Study, looked at five health complications and co-morbidities of diabetes, including: retinopathy (eye disease), diabetic kidney disease, peripheral neuropathy (altered sensation in the feet), arterial stiffness and high blood pressure. The researchers studied 1,746 adolescents and young adults with type 1 diabetes and 272 with type 2 diabetes. Their findings showed that, after less than eight years following a diagnosis, approximately one-third of teenagers and young adults with type 1 diabetes and almost 75 percent of those with type 2 diabetes had at least one health complication or comorbidity. Additionally, any adjustment for differences in age, sex, race/ethnicity, and levels of glucose control over time, did not remove the excess prevalence among those with type 2 diabetes. "The high burden of early complications in youth with diabetes requires additional research to clarify the underlying causes and to identify effective intervention strategies," said Dr. Dana Dabelea, lead author and co-chair of the national SEARCH Study and professor of epidemiology at the Colorado School of Public Health at the University of Colorado Anschutz Medical Campus. "It is extremely useful to have these estimates of the presence of complications in adolescents and young adults who are being treated with current therapies, especially because the complications are frequent. We need to make sure each risk factor is under the best control possible to reduce future problems." The SEARCH for Diabetes in Youth Study has been monitoring the burden of diabetes in youth with onset less than 20 years of age since 2000. Five U.S. clinical centers and principal investigators participated, including: Seattle Children's Hospital, (Dr. Catherine Pihoker); Kaiser Permanente Southern California, (Dr. Jean Lawrence); Colorado School of Public Health (Dr. Dana Dabelea); Cincinnati Children's Hospital, (Dr. Larry Dolan); and the Universities of North and South Carolina Schools of Public Health, (Dr. Elizabeth Mayer-Davis, SEARCH co-chair). The central laboratory is at the Northwest Lipid Research Laboratory, (Dr. Santica Marcovina) and the Coordinating Center is at the Wake Forest School of Medicine (Dr. Ralph D'Agostino and Dr. Lynne Wagenknecht, co-directors). SEARCH is funded by the National Institutes of Health and the Centers for Disease Control and Prevention. The Colorado School of Public Health is the first and only accredited school of public health in the Rocky Mountain Region, attracting top tier faculty and students from across the country, and providing a vital contribution towards ensuring our region's health and wellbeing. Collaboratively formed in 2008 by the University of Colorado Anschutz Medical Campus, Colorado State University, and the University of Northern Colorado, the Colorado School of Public Health provides training, innovative research and community service to actively address public health issues including chronic disease, access to healthcare, environmental threats, emerging infectious diseases, and costly injuries.